What is a Gastric Band?
Gastric Banding (also referred to as Lap Band surgery) is a purely restrictive type of weight-loss surgery (bariatric surgery). It involves in wrapping an adjustable silicon band around the upper part of the stomach to create a narrowing outlet effect and thereby limiting the capacity of food that can be stored in the upper stomach.
When the band is inflated with fluid, the stomach is effectively separated into 2 compartments: a small, upper pouch (above the band) which holds roughly 50-100ml and a much larger, lower stomach compartment (below the band).
The upper pouch of stomach becomes the functional part in terms of storage and, as it is small, it fills up quickly with food giving an early feeling of fullness or satiety. This helps to limit excessive intake of food and thus results in weight loss.
The restriction of outflow of food from the upper pouch to the lower part of stomach can be increased or decreased by the amount of fluid placed in the band through an access port under the skin of the abdomen.
The excess weight loss is expected to be around 30-40%. *
* Individual results may vary. Refer to our disclaimer
Why should you have weight loss surgery?
- It is the only treatment that is proven to be effective and sustainable for weight loss in the long term
- Lowers the risk of developing obesity-associated cancers
- Type 2 diabetes and many other obesity-associated diseases are often prevented, improved or cured
- Improvement in fertility (Especially in those with Polycystic Ovarian Syndrome)
- Allows you to live a longer, happier and healthier life!
* At Melbourne Weight Loss Centre, we provide personalised treatments that are tailored to your individual needs and your existing medical conditions.
Why choose to have a Gastric Band?
Lap-Band surgery has the lowest risk profile and complication rates compared to the other weight lost surgery on offer. It is therefore considered to be the safest. However, it requires a greater degree of commitment from patients in terms of adhering to dieting in order to reach to the expected weight loss goals. This is due to the procedure relying on a purely restrictive mechanism to achieve weight loss and lacks the hormonal and malabsorptive components seen in other weight loss operations. It also requires more frequent follow-up visits with your surgeon or bariatric physician in comparison.
Who is best suited to Gastric Banding?
- Patients who prefer the safest procedure which is also reversible (but accepts the limitiations in the amount of weight loss which is generally lower than other operations)
- Patients who are very disciplined and committed to lifelong dietary, exercise and behavioural modifications
- Patients who are preferably in the lesser obesity severity category
- Age greater than 70 years and should therefore undergo the lowest risk procedure
Indications for Gastric Band
Lap-Band surgery is indicated for morbidly obese individuals with the following criteria:
- BMI is ≥ 40
- BMI is 35-39.9 with at least one or more associated co-morbidities such as type 2 diabetes, high blood pressure, high cholesterol level, heartburn, joint problems, breathing problems (obstructive sleep apnoea), etc…
- BMI is 30-34.9 with uncontrolled or poorly controlled type 2 diabetes with multiple anti-diabetic medications
* Please remember this is a guide only (rather than absolute indications for surgery) and it should be used as an educational reference. The information provided does not replace a medical consultation from the healthcare professional. An individual’s suitability for surgery should be assessed by an appropriately trained doctor on a case by case basis.
Advantages of Gastric Band
The main advantages of this procedure over other type of weight loss surgeries are:
- Shorter hospital stay and quicker recovery
- Lowest risk for immediate/early post-operative complications
- No resection of stomach or bowel and no alteration/re-routing of gut anatomy
- Low risk of protein malnutrition/vitamin deficiency
Disadvantages of Gastric Band
- Slower and less early weight loss than sleeve gastrectomy or gastric bypass
- Higher rate of inadequate weight loss compared to sleeve or bypass
- Higher rate of weight regain compared to sleeve or bypass
- Risk of band slippage or erosion into stomach
- Risk of mechanical issues with band, tube or port
- Dilatation of the oesophagus can occur if patient overeats
- Foreign body (band, tubing and port) remain in the body
- Requires strict adherence to post-op diet and more frequent post-op follow-up visits
- High re-operation rate
Risks and Complications of Gastric Band
As with any major surgical procedure, Lap band surgery also carries some potential risks to the patient.
The immediate/early complications are rare and they include:
- Internal bleeding
- Blood clots in legs or lungs
- Oesophageal/stomach perforation
There are also risks of late complications associated with this procedure such as:
- Infection to the access port
- Damage to tubing near access port causing deflation of band
- Access port can flip and become inaccessible for band adjustment
- Band slippage causing obstruction to stomach
- Band erosion into stomach
- Oesophageal dilatation
- Heartburn/reflux oesophagitis
- Internal hernia caused by tubing leading to bowel obstruction
Gastric Band Procedure
Lap-Band surgery is performed laparoscopically (key-hole surgery) under general anaesthesia. Your surgeon makes 4-5 small incisions in the abdominal wall through which a camera and surgical instruments can be inserted into.
The band is placed around the upper part of the stomach to divide it into two sections: a small, upper pouch and a large, lower compartment. The band is then fastened and secured to the stomach with sutures. In order to adjust the band, an access port is connected to the band and placed under the skin of the abdomen. This enables your surgeon to loosen (deflate) or tighten (inflate) the band by injecting or aspirating sterile water into the port as needed. Finally, the incisions are closed.
Post Gastric Band Care
After the surgery, you are required to stay in the hospital overnight for observation. You will be given pain medications to keep you comfortable. Your nurse will help you to move at the earliest after the surgery to prevent blood clots, respiratory problems and bedsores. To check if the lap band is in appropriate position, an X-ray of your stomach will be performed the day after your surgery. You will be kept on a liquid diet for the first 1-2 weeks. Your surgeon or dietician will give you a specific diet plan and instructions to follow after the surgery. It is important to drink plenty of fluids throughout the day to avoid dehydration.